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Family Financial Disclosure Form for COVID-19 Injections

The goal of this Family Financial Form is to ensure that an adverse event or death of one family member does not translate into long-lived or permanent financial destruction for the entire family.

This form was created to assist families to communicate regarding and to prepare for the family-wide financial impact of adverse events, if any, resulting from a Covid-19 injection. Examples of adverse events from Covid-19 injections include Covid-19 infection; anaphylaxis; neurological disorders; autoimmune disorders; other long-term chronic diseases; blindness and deafness; infertility, fetal damage, miscarriage, and stillbirth; and death (see Table 1 for examples of each).

Disclaimer: This form is provided to facilitate effective family due diligence, communication, and planning. It is essential that each person and each family take responsibility to identify and access the information they believe to be most relevant to their situation and decisions, and take responsibility to assess and manage their individual and collective risk as they believe best.

Source: Family Financial Disclosure Form for COVID-19 Injections

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